NPI | 1821512385 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017006116) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209015923) |
363L00000X Nurse Practitioner (Licence: MO 2017006116) | |
363LF0000X Nurse Practitioner, Family (Licence: IL 209015923) | |
Enumeration Date | 2017-07-26 |
Last Update Date | 2021-08-30 |